Neurocirugía is the official Journal of the Spanish Society of Neurosurgery (SENEC). It is published every 2 months (6 issues per year). Neurocirugía will consider for publication, original clinical and experimental scientific works associated with neurosurgery and other related neurological sciences.

All manuscripts are submitted for review by experts in the field (peer review) and are carried out anonymously (double blind). The Journal accepts works written in Spanish or English.

CiteScore measures average citations received per document published. Read more

CiteScore 2017

0.38

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR

0.228

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

Objectives: Medullary glioblastomas are highly infrequent lesions. Usually, they appear late in the course of treated cranial glioblastoma as a spinal drop-like metastases, being extraordinary its diagnose as an initial manifestation and isolated lesion. We report a rare case of an unique intramedullary tumor as an initial manifestation of a multicentric glioblastoma multiforme.

Methods: A 35 year-old male came to our hospital complaining of uncontrollable radicular pain and sphincter dysfunction during last three months. Neurological examination evidenced distal weakness in both lower limbs and paresthesia. A spinal axis MRI revealed an unique conus medullaris tumor. Under suspicion of a myxopapillary ependimoma surgical resection was planned.

Results: Laminectomy and gross total resection was done. Unexpectedly, histopathological findings revealed a conus medullaris glioblastoma multiforme. Initially, the patient showed relief of his radicular pain, but not strength improvement. Three days after surgery, he developed severe headache, nausea and vomiting. A CT scan showed multiple intracranial lesions, suggesting multicentric glioblastoma. An hour later the patient suffered a sudden deterioration with an episode of seizures. A new CT scan evidenced hemorrhagic transformation of cranial lesions and acute hydrocephalus associated. Due to his poor prognosis supportive care was offered.

Conclusions: This case emphasize how complete neuroaxis studies can dramatically change treatment and prognosis in a medullary lesion. In this case, initially palliative care would have been considered. Spinal glioblastoma metastases are commonly asymptomatic. Autopsy studies in which patients had no signs or symptoms of spinal metastasis have been documented, with rates of postmortem CSF spread ranging from 20% to 60%. According to the literature, most secondary GBMs come from previous intracranial GBMs. To our knowledge, this is the first report of a spinal intramedullary tumor diagnosed as an isolated lesion and synchronously to a cranial glioblastoma.